Intermenstrual Bleeding

Refer to Menstrual Disorders Clinic with pelvic USS attached

Definition

Vaginal bleeding (other than post coital) at any time in the cycle other than during normal menstruation

Urgency

• Persistent  bleeding in >45 years or risk factors  eg obesity, PCOS unopposed estrogen, tamoxifen) –Refer urgently and request USS
• Suspicious cervix on examination- Refer  2ww
• Otherwise routine referral

 

Information to include in referral letter 

• Problem and length of symptoms
• Current contraception
• Smear history (including last smear & result) the patient will still be seen without this but if you can retrieve it automatically it speeds up the consultation 
• Speculum findings (eg normal / ectropion / cervicitis / cervical polyp) 

Investigations prior to referral

• Chlamydia screening
• High Vaginal Swab
• Pelvic USS
• NB DON’T perform a cervical smear if outside the screening programme

 

Date Reviewed                        27/6/2019

Next Review Date        27/6/2020

Dr Anna Harrold

 

Version 2.0